Carpelan-Holmström M, Nordling S, Pukkala E, Sankila R, Lüttges J, Klöppel G, Haglund C
Department of Surgery, Helsinki University Central Hospital, Finland PO Box 340, Helsinki, Fin-00029, Finland.
Gut. 2005 Mar;54(3):385-7. doi: 10.1136/gut.2004.047191.
Worldwide survival data for ductal adenocarcinoma of the pancreas are the lowest among the 60 most frequent types of organ cancers. Hence published data on long time survivors of this disease are controversial. We performed a nationwide study comprising all Finnish patients diagnosed with pancreatic cancer in the period 1990-1996 who survived for at least five years after diagnosis.
Data on patients registered as five year survivors of pancreatic cancer were obtained from the Finnish Cancer Registry and Statistics Finland. Slides or paraffin blocks were collected from patients recorded as having histologically proven pancreatic ductal adenocarcinoma (PDAC) and were re-evaluated in a double blind fashion by three pathologists with special expertise in pancreatic pathology.
Between 1990 and 1996, the Finnish Cancer Registry recorded 4922 pancreatic cancer patients, 89 of whom survived for at least five years. Reviewing this series of patients revealed 45 (49%) non-PDACs and 18 cases without histological verification. In 26 patients recorded as having histologically proven PDAC, re-evaluation of histological specimens confirmed PDAC in only 10 patients.
This study indicates that (1) the prognosis of PDAC remains poor and (2) careful histopathological review of all patients with pancreatic cancer is mandatory if survival data are to be meaningful.
在60种最常见的器官癌症中，胰腺导管腺癌的全球生存率数据是最低的。因此，关于这种疾病长期存活者的已发表数据存在争议。我们开展了一项全国性研究，纳入了1990年至1996年期间在芬兰被诊断为胰腺癌且诊断后存活至少五年的所有患者。
从芬兰癌症登记处和芬兰统计局获取登记为胰腺癌五年存活者的患者数据。从记录为组织学确诊为胰腺导管腺癌（PDAC）的患者中收集切片或石蜡块，并由三位胰腺病理学专家以双盲方式重新评估。
1990年至1996年期间，芬兰癌症登记处记录了4922例胰腺癌患者，其中89例存活至少五年。对这一系列患者的复查发现45例（49%）不是PDAC，还有18例未经组织学证实。在记录为组织学确诊为PDAC的26例患者中，对组织学标本的重新评估仅在10例患者中确认了PDAC。
本研究表明：（1）PDAC的预后仍然很差；（2）如果要使生存数据有意义，对所有胰腺癌患者进行仔细的组织病理学复查是必要的。
